Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Oct 2010
Case ReportsLeft-sided atrial flutter originating in the coronary sinus after radiofrequency ablation of atrial fibrillation.
We describe a case of atypical atrial flutter presenting 1 year after radiofrequency ablation for atrial fibrillation (AF). Electrophysiologic study showed a reentry circuit involving the inferolateral aspect of the mitral annulus and the coronary sinus (CS); however, a mitral isthmus line did not terminate the arrhythmia. ⋯ Radiofrequency energy applications from within the CS terminated the tachycardia. Mapping and ablation within the CS should be considered in patients with post-AF ablation arrhythmias, particularly when the mitral annulus appears to be involved in the tachycardia circuit.
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Pacing Clin Electrophysiol · Oct 2010
Randomized Controlled TrialComparison of surgical cut and sew versus radiofrequency pulmonary veins isolation for chronic permanent atrial fibrillation: a randomized study.
Surgical pulmonary veins isolation (PVI) is done to restore sinus rhythm (SR) in patients with chronic permanent atrial fibrillation (CPAF) and mitral valve disease. Here we compare the efficacy of electrical block lines performed with radiofrequency (RF) compared with conventional surgery. ⋯ PVI by SURG formed more effective block lines than RF. SR at hospital discharge was similar among the groups, but more amiodarone was used in RF. During follow-up, incidence of recurrent AF was higher in the RF group.
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Pacing Clin Electrophysiol · Jun 2010
Characteristics of telemetry interference with pacemakers caused by digital media players.
Contemporary implantable heart rhythm devices communicate multiple complex data simultaneously using radiofrequency telemetry. Interference in communication can expose them to the risk of potential corruption, leading to adverse clinical consequences. ⋯ Low-power MFE from iPods can produce interference with establishment and maintenance of a telemetry link and can cause TI with transmission of real time data, but because of continuous check protocols, do not corrupt the stored and vital downlink data.
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Pacing Clin Electrophysiol · Jun 2010
Case ReportsHigh efficacy of disopyramide in the management of ventricular fibrillation storms in a patient with Brugada syndrome.
The patient was a 57-year-old man with Brugada syndrome, who had been implanted with a implantable cardioverter defibrillator (ICD). The frequency of ventricular fibrillation (VF) started to increase about 4 years after ICD implantation, occurring, at worst, six times in one night. ⋯ Thereafter, VF completely stopped occurring. Findings observed in our case suggest that disopyramide could be added in our arsenal of medications for treating arrhythmic storms in patient with Brugada syndrome.
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Pacing Clin Electrophysiol · May 2010
Heart rate-dependence of QTc intervals assessed by different correction methods in patients with normal or prolonged repolarization.
There is a continuing debate about the optimal method for QT interval adjustment to heart rate changes. We evaluated the heart rate dependence of QTc intervals derived from five different QT correction methods. ⋯ Of the studied QTc formulae, the Bazett appeared the most heart rate dependent. Our results suggest the use of Hodges and the Karjalainen-Nomogram secondly to ensure least heart rate dependence of QTc intervals in patients with either normal or prolonged repolarization.